NPI 1235670126

Michael G Short, BSCPED

Practitioner Pedorthist Clackamas, OR

Practice location

Address: 10117 SE Sunnyside Rd. STE. H, Clackamas, OR 97015
Phone: (503) 305-7254

Registered specialties

Pedorthist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224L00000X Licence CPED4280 (OR)

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Registry record

NPI: 1235670126
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Mar 2017
Record last updated: 13 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.